The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Eur J Clin Invest. 2010 May;40(5):433-9. doi: 10.1111/j.1365-2362.2010.02270.x.
In most cases of renal cell carcinoma there is no family history of renal cancer and no hereditary cause of the disease. Hereditary renal cancer accounts for about 2-4% of cases. Recognition of this subgroup by clinicians is important because of the possibility of severe medical consequences for patients and their relatives.
We review the latest data about different genetic conditions characterized by an increased risk of developing renal cancer and we formulate tools to recognize high-risk families.
In general, a positive family history, young age at diagnosis of renal cancer, multiple and/or bilateral renal tumours and combined occurrence of different histological types of renal tumours should raise suspicion of a hereditary renal tumour syndrome. In addition, the presence of specific extrarenal symptoms in patients could assist in differentiating between tumour syndromes.
A detailed medical and family history, along with physical examination are key factors to diagnose hereditary renal cancer syndromes. When a genetic predisposition for renal cancer is suspected, referral to a Family Cancer Clinic is warranted to initiate genetic examination and counselling on preventive options.
在大多数肾细胞癌病例中,没有肾癌家族史,也没有疾病的遗传原因。遗传性肾癌约占病例的 2-4%。临床医生识别这一亚组很重要,因为这可能对患者及其亲属产生严重的医疗后果。
我们回顾了最新数据,这些数据涉及具有增加患肾癌风险的不同遗传状况,并制定了识别高危家族的工具。
一般来说,阳性家族史、肾癌诊断年龄较小、多发和/或双侧肾肿瘤以及不同组织学类型的肾肿瘤同时发生,这些都应引起对遗传性肾肿瘤综合征的怀疑。此外,患者存在特定的肾外症状有助于区分肿瘤综合征。
详细的病史和家族史以及体格检查是诊断遗传性肾癌综合征的关键因素。当怀疑存在肾癌的遗传易感性时,应转至家庭癌症诊所进行基因检查,并提供预防性选择的咨询。